Tuesday, December 21, 2010

For those who know me, I think most would describe me as being a pretty feisty character. I make up for my vertically challenged 5'1" self by having a large personality and a seriously scrappy side. Now granted... I have my moments where confrontation is difficult and there are times when I think I could use a little more gusto in speaking up for myself... but on the whole... sharing my opinion is not usually an issue of mine.

In a lot of ways I think its a very necessary trait to have as an ICU nurse... especially an ICU nurse working in a teaching hospital. I know I've mentioned it before but I will say it again... working in an environment where sometimes the physicians you are working with have such little clinical experience can be tough because often times we are all learning together.

In my unit the residents and interns cycle through their ICU rotation on a monthly basis. When I first started working here it was completely discombobulating because every month... just as the old ICU team settled into their routine and figured out how we worked here ( and usually just as I was remembering their names)... they were headed off to their next rotation and we were left to adapt to a whole new set of residents and interns. It's tough also because with each new set of folks you have to figure out which ones have more experience and which ones work well with the nurses.... which ones are good about putting in orders when you ask them to and which ones will actually work with you and not above you... if you know what I mean. To put it plainly... the rotation process of working in a teaching hospital sucks.

But... now that I'm starting to head well into my second year in the ICU there are some things that I am starting to really appreciate about the teaching hospital environment. One thing I have really been loving recently is the fact that I'm starting to see some of the physicians come back for their second rotation here. Those scared, unsure interns that we worked with last year are now coming back as confident, more experienced residents... and not only that but most of the time I know them well and have built a rapport with them which is so cool. I love seeing the growth in them and I love feeling invested in their growth as burgeoning, competent doctors.

What's even better about it, is that in many ways I think we as nurses can be a strong resource of clinical experience and encouragement for them (or a serious pain in the you know what... if you so choose). I have to admit that I have been known to have my bad days with interns... especially when they decide to do basically everything in the book to irritate you.

But now that I'm starting to see these people come back through their second ICU rotations... I understand the value in actually investing into each one of them...

A few weeks ago we had an intern in our unit who managed to do basically everything on the "How to piss off your nurse" list and it ended up being a very rough night. Poor thing was trying so hard to be nice and I don't think she had any clue what she was doing but I wasn't reciprocating the friendliness. When the morning came around and she thanked me for doing such a good job and acknowledged how busy the night was... my response was less than friendly, "Just part of the job I guess... but I appreciate that." My tone was not enthusiastic.

Then a few nights ago I walk into our breakroom and this same intern left one of the most thoughtful notes on our bulletin board. She thanked us all for being the "best and most intelligent nurses" she has ever worked with... "Thank you for teaching me, guiding me, feeding me and making me a better doctor!"

Instantly I felt like a terrible person because I knew that the one on call night I had with her was completely horrendous. I guess the good news is that I definitely learned a good lesson here... no matter what the situation... there is always room for more humility and grace on my part... and also...a genuine thank you seriously goes a long way.

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